习惯上对于有疑问的甲状腺结节的手术计划是先采用诊断性腺叶切除,再根据其冰冻切片的检查结果决定手术的范围。但其假阳性和假阴性的结果常使外科医生遇到治疗上的困难。针刺活检已广泛用于甲状腺结节的检查,且对于大多数良、恶性肿瘤具有相当高的诊断可靠性。本文旨在研究甲状腺结节针刺活检能否代替冰冻切片来指导手术计划。作者等在1978～1983年间为2,500例甲状腺结节患者作了针刺活检,其中501例作了手术。分析对象中不包括未分化癌、淋巴瘤及甲状腺转移癌。取针刺活检和冰冻切片检查结果进行对比,根据针刺活检诊断为癌肿的可能性-概率大小分成下列三组:(1)低概率组,共149例,最终诊断为良性肿瘤134例,恶性肿瘤15例。针刺活检全部诊断为良性肿瘤,误 The customary surgical plan for questionable thyroid nodules is to use diagnostic lobectomy first, and then determine the scope of the surgery based on the results of its frozen section. However, the results of false positives and false negatives often make surgeons encounter treatment difficulties. Acupuncture biopsy has been widely used for the examination of thyroid nodules and has a high diagnostic reliability for most benign and malignant tumors. This article aims to study whether thyroid nodule biopsy can replace frozen sections to guide surgical planning. The authors performed acupuncture biopsy for 2,500 patients with thyroid nodules from 1978 to 1983, of whom 501 had undergone surgery. Unanalyzed cancer, lymphoma, and metastatic thyroid cancer were not included in the analysis. The results of acupuncture biopsy and frozen section examination were compared. The probability of diagnosis based on acupuncture biopsy was divided into the following three groups: (1) low-probability group, a total of 149 cases, 134 cases of benign tumors were eventually diagnosed. There were 15 cases of malignant tumors. All acupuncture biopsy was diagnosed as benign tumor.